Monday, September 21, 2009

During my hariraya visit to my grand uncle's house yesterday, from his neighbour's house suddenly blasted a long chain of fire crackers with avery loud unwanted sound. Of course it causes NOISE - one form of physical hazards. In my experience, the intensity of that noise must be between 90 to 105 dB (based on this field study).The firecrackers' noise lasted for more than 5 minutes. I managed to record it at its last part(about24 seconds duration). My ears feel discomfort although I was sitting in my granduncle's house about 20 feet away and it also annoyed our conversation.I supposed, it not only can cause 'temporary standard shift (TTS)' to my hearing but also can cause physical injury. I hope this 'hariraya' celebration will not end up with tragic otherwise

Tuesday, September 15, 2009

Medical adage, "Prevention is Better Than Cure", is one of the health principle we should practice in our daily life. Health Prevention refers to any activity we do that prevent the health from harm. The fact is Prevention is cheaper than Treatment cannot be disputed.

Prevention Mode of Action can be classified into 3 stages:

1. Primary Prevention

2. Secondary Prevention

3. Tertiary Prevention

Primary Prevention:

In primary prevention stage, the main activities are to prevent disease or injury from occuring. Primary Prevention can be done at individual and community level. The focus of activity in primary prevention stage can be directed at host in order to increase his resistance to the agent, for instance by giving immunisations, stop smoking et cetera. Primary prevention activity also can be directed on the environment such as reduce the condition favorable to the vector of the agent such as in biological hazards (example:Fogging to destroy aedes mosquito inorder to prevent Dengue disease). The acitivities in primary prevention do not depend on the doctors alone.Health Protection and Health Promotion are the two tools widely used in primary prevention.

In Health Protection, the main aim is to eliminate the agent and also any predisposing factors that can cause the disease. Hierarchy of Control is included in this Health Protection tool. Health Promotion is another tool that not only give the health education to the individu but also empower them to take care and responsible of their own health.

Secondary Prevention:

In Secondary Prevention the main aims is to detect the disease early and manage it as early as possible to prevent its complication. Detection of disease can be made through health screening, health and medical surveillance. In our current contact of handling influenza A H1N1 infection both homequarantine and mitigation phase are belong to this stage of prevention.

Tertiary Prevention:

Tertiary Prevention are activities which promote rehabilitation, restoration and maintenance of maximum function after the disease and its complications have stabilised. The activities are directed at host and also environment.

Before we explore 'Health Prevention Concept' further, it is important at this juncture to understand another paradigm called 'Host-Agent-Environment' which contributes to ill health condition. In this paradigm, the Host, Agent and Environmentinteract with each other to form a condition that favors ill health or disease to occur. The Host is the person who has or at risk of specific disease. The Agent is the organism or direct cause of the disease. In occupational health we called its health hazards categorised as Biological, Chemical, Ergonomics, Physical and Psychological (BCEPP). The Environment includes the external factors which influence the host or his susceptibility to the agent and also the vector which transmits or carries the agent from the environment to the host. This paradigm explains the causation and transmission of many diseases. The combination of factors in these 3 premises in effects form a contagion of theories of disease causation.

The factors in the host which contributes to his susceptibility to the disease are age, gender, genetic, occupation, lifestyle, education etc. The agent's factors which contribute in disease susceptibility in the host are biological, type, characteristics etc. The factors in the environment are the economic, social condition,climate etc. This 'Host-Agent-Environment' complex interaction only can cause disease with Allah Willing.

Sunday, September 13, 2009

In my last posting, I concluded that WHO's definition of health can be accepted as an ideal goals that everybody should achieve. The state of complete physical, mental, spiritual and social well being is the state of being in equalibrium. But in reality, health is a continuous responding process of adjustment of the four mentioned human dimensions to the demands of everyday life. These demands arise as a result of the interaction between ourselves with others and our environment. In simple word, we live in the interactive ecology system. So, to preserve our health in the state of complete well being, we cannot act alone. We need a balance interactive of this ecosystem so that it is always in equilibrium states or state of well being. So the responsiblilty to preserve health is beyond individual; it also involves the active role of the family, society and environment. In the nutshell,we need a maintenance of health preservation effort at individual level and also a health protective and promoting system at the family, society and environment level.

The understanding of this concept of health is very important especially when we want to explore occupational health (and also public health). Occupational health is the specific subset of the public health which focus its prevention activity by protecting and promoting health at workplace. The 'workplace' is the domain of occupational heath function. In the 'worker-workplace' ecosystem, workplace is the society and environment components. Since the worker is part of the population, the population as whole and a family as a specific origin of the worker also play a vital role in maintenance the state of well being of the worker.

Workers who come from families of the society in the population, brought with them their health state, belief and behavior to their workplace. At workplace they form an interactive mini ecosystem with the workplace and its environment. This mini ecosystem is a subset of a big ecosystem in the family, society and the population.

In preserving the workers' health, all the components of this mini ecosystem as well as the entire ecocystem have their roles to play. These roles must be integrated.

So the health prevention is an integrated functions which involved the worker, the workplace (the management,peer workers) and the environment (organisation, job task, building ec cetera.).

Health Prevention can be simply defined as stopping or eliminating the factors that can disturb the equilibrium of health. It involved protection and promotion of health at workplace. This is the main 2Ps activities of occupational health.

The soul of occupational health is prevention; its functions are to protect and promote the health of people at workplace. The key words here are Prevention, Health and Workforce(people at workplace). Let us understand the definition so that we don't have confused understanding.

According to WHO,HEALTH is defined as astate of complete physical, mental and social well being AND not merely the absence of disease or infirmity. Health is multidimensional. In this definition, WHO focuses on 3 specific dimensions of health namely Physical, Mental and Social.

However, in this posting I would like to add another dimension called spiritual to this definition. So now, our definition of health is " a state of complete Physical, Mental, Spiritual and Social well being". In this new definition, it is better to differentiate between mental health and spiritual health.

Mental health is a state of emotional and psychological well being in which an individual is able to use his or her cognitive and emotional capabilities to function in the society and meet ordinary demands of everyday life.

Spiritual health on the other hand is individual ability to differentiate between Right or Wrong and resolve to lead a more righteous life, free of stratagems, deception, dishonesty and selfishness.

To perceive health as a state at all is too idealistic. However, it is the ideal goal that everyone should achieve. In real fact, health is a process of continous adjustment to the changing demands of life.

Thursday, September 10, 2009

Last week, I asked my ordinary grass cutter came to do his job at my house compound. He knows the hazards of his job and he voluntarily used all the necessary Personal Protective Devices(PPD/PPE) according to his own standard.(Cover his face&head, using google, using long sleeve and using PCK safety boot). His self-compliance without even knowing the existence of OSHA 1994 is very much appreciated.

When come to safety, our inner self is fully aware to protect ourself from dangers. However, a lot of the time we see people totally ignorance about their safety especially on the road and at their workplace. They do unsafe acts and create unsafe conditions (the two culprits of accident)and it becomes their routine or behavior. Their mindset already corrupted by false satisfaction they get from the non accident consequences they get from their actions and conditions. This false satisfaction is like 'atomic bomb waiting to explode'. The vital question is : Can we change their practices or behaviour?

Definitely........ we need to change their mindset first....changing their mindset means changing their perception or to be accurate change their 'world view'. We only can change their 'world view' by giving them 'knowledge' (ilmu) using simple language that they can understand. By changing their mindset, only then they will change their behavior. In another word, we are talking about 'Behavior Based safety'. We have to use a lot of approaches including religion approach. In religion there are a lot of safety values we can practice.